5 tips to prevent holiday weight gain & stay active

1) Hydrate
H2Oooooohhh yeah! Drink a large (16 oz.) glass of water 15-30 minutes before every meal, especially before hitting a holiday buffet. Water will help you feel fuller, eat less and aid in the digestion process.

2) Indulge in moderation
Deprivation is a recipe for disaster, but so is unlimited indulgence. Find a happy balance and allow yourself 2 or 3 small portions of your favorite holiday treats. For the rest of the meal, stick to healthier options like veggies, lean meats, low fat cheese and fruit.


3) Weigh in
While it’s tempting to reach for elastic waist pants and hide your bathroom scale for the month of December, neither will help keep you accountable. If you see the number on the scale creeping up or feel your favorite pants getting tighter, you’ll likely pass on that slice of pie.

Think you can take an accountability hiatus and start again in the New Year? Neglecting healthy eating habits and exercise during the holidays will only make your resolutions more difficult.

4) Make exercise appointments
Consistent exercise and protected time to de-stress are more important than holiday shopping and gatherings. To avoid making excuses or falling into the trap of being “too busy”, schedule exercise on your calendar just like you would any other meeting. Bonus, you can even set an event reminder alarm to alert you it’s time to get moving!

5) Share fitness with loved ones
The best part of the holiday season is spending time with friends and family, so connect while staying active! Take an after dinner walk with your kids, go hiking with your cousins, attend a fitness class with your best friend, or register for a fun 5K. Make fitness a new part of of your holiday tradition!

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Healthier Options: Thanksgiving Edition!

I LOVE the fall and winter holidays!  The sights, the sounds and especially the holiday FOOD.  I remember as a kid, the scent of my Mom’s turkey and gravy wafting through the house on Thanksgiving Day.  My family and I would indulge ourselves on the bountiful feast spread before us and celebrate the holiday giving thanks to family, friends and health.

Fast-forward 20 years and I am going to be preparing a Thanksgiving meal for my OWN family now.  I will definitely have Mom’s recipes in mind and will be trying my hand at lightening some Thanksgiving side dishes so I can stay on a healthy path and not fall into the Thanksgiving “coma” from over-eating heavy foods. 

This year I plan to be a more mindful eater. I will prepare some recipes in advance to test out new, healthier side dishes so I know which ones my hubby will enjoy (and which ones he will attempt to feed the dog on the sly).  I have included some lighter side dish recipes below and encourage you to also experiment on your own!  Have fun this Thanksgiving and remember: It’s a holi-DAY not a holi-MONTH so instead of embarking on a month long food fest, take control of the day and kick-start your motivation for a healthy holiday season!

RECIPES

1.   Healthy Potato Gratin with Herbs: Skip the mashed potatoes this year and try a lighter potato dish that loses the heavy cream but keeps the flavor with fresh herbs.

http://www.foodandwine.com/recipes/healthy-potato-gratin-with-herbs 

(recipe courtesy of Food and Wine)

2.   Cider-Glazed Roasted Root Vegetables: Instead of a basic sweet potato/yam dish, try this delicious recipe that brings an added sweetness with apple cider.

http://thescrumptiouspumpkin.com/2014/11/25/cider-glazed-roasted-root-vegetables/ 

(recipe courtesy of the Scrumptious Pumpkin blog)

3.  Cranberry-Pear Wild Rice Stuffing: Take unhealthy “stuff” out of your Stuffing this year with wild rice, whole grain bread and dried cranberries.

    http://www.vegkitchen.com/recipes/cranberry-pear-wild-rice-stuffing/ 

(recipe courtesy of the VegKitchen with Nava Atlas blog)

How to Prepare for Your PRP Visit and What to Do After

Platelet-Rich Plasma (PRP) is an example of proliferative therapy that we’ve discussed on this blog before. The treatment is useful for many musculoskeletal disorders, ranging from lingering tendon, ligament, and muscle injuries (e.g. hamstring and rotator cuff tears) to joint pain (e.g. knees and hips). We at Lake Washington Sports and Spine tend to recommend PRP after other conservative measures, particularly physical therapy or chiropractic care, have not produced meaningful results.

PRP is one of many treatments that we perform in the office, but it is one of the more time-intensive ones. This is due to the nature of the therapy itself. When we perform other injections in our office, medications are drawn from vials then injected into a patient. However, with PRP, the medication comes from the patient! Our blood is not just a homogenous red substance that courses through our veins. There are many types of cells in our blood – which include, but are not limited to – cells that carry oxygen, others that fight off infection, and the ones we are most concerned about: the healing factors.

These healing-inducing cells include platelets, as you probably guessed by the name of the therapy. The portion of plasma containing platelets - as well as other healing factors - is obtained by spinning blood in a centrifuge for 15 minutes, which separates the different aspects of the blood into distinct layers. The platelet-rich concentration is extracted from the resulting vial of separated blood, and injected under ultrasound guidance into the site of injury. This not only concentrates healing factors near the injured area (exactly where it needs to be), but also causes an inflammatory cascade which brings its own set of healing responses.

What can you do to prepare for the procedure itself?

1.     Come early.  Coming in 30 minutes prior to your appointment start time allows us to perform all the steps (draw, centrifuge, and platelet extraction) before the actual injection without making your appointment run late. It also gives us a time buffer in case we run into any issues during the blood collection. Additionally, this time is beneficial to patients as it gives them a time to relax between the blood draw and the injection. If you do not arrive 30 minutes early, there is a chance your procedure will need to be rescheduled. 

2.     Hydrate! Water is an important component of blood, and makes it much easier for any healthcare professional to draw blood from your arm. Your veins are fuller (making it easier to perform the actual blood draw) and your blood moves quicker (less time with a needle in your arm!).

What do you need to do after the procedure?

1.     Rest and get more sleep. Sleep is a wonderful thing, so I feel strange having to recommend it. But many patients do not get enough sleep, and lack of sleep can have a very detrimental effect on your healing rate. Use this procedure as an excuse to get more restful sleep. I recommend using your recovery phase from this procedure as a jumping off point to establish a good sleep routine you can use when you’re back to your fully functional self.

2.     Limit forceful weight bearing and movements with excessive range-of-motion.  Imagine a glob of peanut butter sandwiched between two saltine crackers. Now imagine squeezing the crackers together and spilling the peanut butter onto the floor. You don’t want peanut butter on the floor, just like how you don’t want the Platelet-Rich Plasma anywhere other than where your injury is located. The general idea behind PRP therapy is to concentrate healing factors into a specific, targeted area. An excessive contraction of a muscle, or movement of a joint past normal range-of-motion, can “squeeze” the platelets away from the targeted area. For some cases when the PRP is meant for a lower body part, we may recommend being on crutches for two weeks to really ensure the PRP stays where it should.

3.     NO NSAIDs.

4.     I repeat, NO NSAIDs. Your body’s natural response to injury is to cause inflammation. We typically only associate inflammation with pain, which is why people often take an NSAID (non-steroidal anti-inflammatory drug) like ibuprofen or naproxen (e.g. Advil, Aleve). However, inflammation also triggers a healing response by the body. PRP therapy will cause some inflammation and therefore may increase a patient’s pain level for the first two weeks. This is a completely normal part of the healing cascade, and is temporary. Taking NSAIDs to alleviate the temporary pain will reduce the likelihood of having a more permanent recovery. Do not sabotage your ultimate goal of getting back to fully functional activity for some temporary relief. Keep your end goal in mind!

5.     Ice if necessary, Tylenol if necessary. If you’ve been to our office, you know that we extol the benefits of ice like we’re the ice farmers of Frozen. We recommend ice as our first-line pain reliever, as ice has been shown to reduce pain and inflammation without having to take medication. However, PRP might be the only instance we recommend discretion when icing. As I’ve said previously, forms of proliferative therapy cause inflammation, so icing is counter to what the therapy is trying to accomplish. Therefore, we recommend icing only when completely necessary and the pain in unbearable. You can also try acetaminophen (e.g. Tylenol), as that is a non-NSAID pain reliever.

And that’s it! This is only a general overview, and I’m sure you might have more questions. The doctors here at Lake Washington Sports and Spine always have a consultation with a patient to review the appropriateness of PRP for a given patient, the risks involved, and potential outcomes. They are more than happy to answer any and all questions you may have regarding this procedure at that time.

Stay active!

Meet the Team: Shannon Mack!

-What is your role at LWSS?  What are some responsibilities​ your ​role ​​entails?

My role at LWSS is Dr. Hyman’s Medical Assistant.  Some of my responsibilities include greeting our patients with a smile and getting to know a little bit about them before they meet with Dr. Hyman; throughout the day, I follow up with patients via phone or email (I prefer to call, its more personal), assist Dr. Hyman when necessary during appointments, turnover exam rooms by cleaning and making sure that inventory is stocked, and help my team with some of their tasks. You will also find me petting Wynnie.

-Tell us a little about you ​and your path leading to LWSS: ​​where are you from originally, where did you go to school, and what drew you to Lake Washington Sports & Spine as a place to work?

What drew me to Lake Washington Sport & Spine started with the opportunity to be a part of a team that is focused on healthy, active lifestyles and helping people achieve just that. I was drawn in from the first opportunity I had to meet the LWSS staff and watched how they interacted with one another.

-Give us 5 fun facts about S.Mack!

I think ice cream tastes better during the winter!

Red is my FAVORITE color (although, I only have one red clothing item)

If I could have just one super power, I would definitely time travel

I am beyond thankful for GPS because maps confuse me

Every day, I take a moment to think about what I am thankful for; doing that really helps me to put life in perspective

-What is your favorite form of exercise?  How do you integrate it into your day?

I love running! It frees my mind and also gives clarity. I like to visualize my run throughout the day, especially if it is stressful. During the week, I prefer to run in the evenings as the day begins to cool. On the weekends, I try to hit the road early when it is still quiet and the air is fresh – after a cup of coffee of course!

-When did you become interested in medicine?  In what ways do you think your time at LWSS will impact your future as a nurse practitioner?

I have been interested in medicine ever since I was a child. I had an inspiring Pediatrician and a mom who always encouraged me to dream (she still does). I remember the moment when I decided I wanted to dedicate my life to serving others through medicine and that has motivated me through the years.  I believe LWSS will impact my future as a Nurse Practitioner in many positive ways – I am in an environment that challenges me to think critically, listen patiently, and reply thoroughly. These are skills that I feel are important for being successful as medical professional. The doctors also encourage you to think like a provider by asking questions related to each case and challenge you to consider other reasons for why and how a diagnosis could be obtained. There are so many learning opportunities here that are invaluable!

-Since you've worked in other clinics, can you provide some examples of what sets LWSS apart from other healthcare facilities?

LWSS is truly special. Dreams, goals, visions are not idle here – we all have them, from our staff to our patients, what we do here is “Keep People Active”  and you can see that demonstrated every day. The team here allows you to be yourself and encourages you to set specific goals. Because they are dedicated to seeing patients and staff succeed, they create a supportive and informative culture. From the moment you walk in, you can feel that you are in a place that creates exceptional and is dedicated to seeing patients rehab their injuries to achieve their goals! At LWSS, you are celebrated, encouraged, and set up to succeed.

-Can you give some examples of the types of patient interactions that drive your happiness at work?

I believe that laughter is necessary for healing; whenever I have a chance to laugh with a patient that makes me feel elated!

There is not a better feeling than hearing someone say ‘thank you’ after you have helped them with a need they have, such as, carrying an item or asking how their day is going. Taking one minute to be present with the patient and listen can be transformative in their experience - and mine.

I LOVE that we celebrate our patients who have completed their treatment with a graduation! In the midst of the cheer, I always look for the smile on their faces because you can see they are proud of what they did - and they trusted our team to help them get there!  

Your tendons on cake

My friend and colleague James Crownover recently wrote a wonderful blog post about the relationship between glucose metabolism and tendon injury

http://crownmd.net/your-tendons-on-cake/

Upcoming Fall Races: 5K, 10K, marathon, fun run, and more

I remember the first 5K I ever did.  It was the charity walk/run called the Furry 5K in Seward Park that benefited the Seattle Animal Shelter.  As a non-runner, I was hesitant at first to sign up because I imagined all these seasoned athletes sprinting past me while I was left in their dust.  Boy was I ever wrong!  The amazing lessons I learned that day were: A. I could power walk at MY pace and still cross the finish line and B. EVERYONE who signs up for these walking/running events is there to support and cheer one another on. 

Whether you are a competitive runner who is pushing their physical capacity in a timed race or a beginner testing the walking/jogging waters in a fun run, there is ALWAYS a race for you!  I am going to share some upcoming races in the Seattle area that I have researched, but remember, do your own research too!  A great website I utilized is http://www.runguides.com/seattle/runs which lets you filter through the types of runs you are looking for.  So check out some of these runs below and as always, stay active and be the BEST version of yourself!

September:

·         “Walk to Defeat ALS”- September 12, 2015 (our clinic completed).  This is a little less than 5K run/walk around Seward Park.  This event is to raise money for local ALS Association chapters to sustain care services and support research.  I will be doing this walk again this year! http://web.alsa.org/site/TR?fr_id=11078&pg=entry#.VdzAwvlVhBc

·         “End Aids Walk and 5k Run Seattle”- September 26, 2015.  This is a 5K run/walk around Volunteer Park.  The monies raised will go towards support in HIV prevention and care services.  https://give.lifelong.org/seattle/events/the-seattle-aids-walk/e48168

October:

·         “Magnolia 10K & 5K”- October 4, 2015. This is a 5K and 10K run/walk in the Magnolia neighborhood of Seattle.  At the finish line, there is a festival in the Magnolia Village that includes exhibitors, food and a beer garden.  http://www.promotionevents.com/magnolia/Info.htm

·         “Biggest Loser Seattle Half Marathon/5K”- October 25, 2015.  This is a half marathon/5K run/walk at Lake Stevens in Snohomish County.  There will be appearances by former contestants from "The Biggest Loser" as well as the Biggest Loser finisher's medal and awards for the best times.  http://www.biggestloserrunwalk.com/race/2015/seattle-wa-half-marathon-5k

November:

·         “The Ugly Sweater Run Seattle”- November 28, 2015 (our clinic completed).  This is a 5K run/walk around Marymoore Park.  You can expect to see tons of ugly sweaters, holiday cheer and and other goodies at the finish line.  Also, this event raises monies for the non-profit Save the Children. http://theuglysweaterrun.com/locations/seattle-washington/#.VdzipflVhBc

·         “Seattle Marathon and Half-Marathon”- November 29, 2015 (our practice manager Laura completed; she and medical assistant James will be at this year’s race).  These marathons are primarily for runners though the race does offer a smaller walker category.  The routes begin near Seattle Center and head out towards Lake Washington.  The best times from the race can be used as a Boston Marathon qualifier; there will also be other medals and awards.  http://www.seattlemarathon.org/amica-insurance-seattle-marathon

December:

·         “Run 4 Wine”- December 12, 2015.  This is a 5K run/walk around the Warehouse Wineries in Woodinville.  Pair your love of running with your love of wine!  After the race, you can enjoy some of our state’s finest wine tasting.  http://www.active.com/woodinville-wa/running/distance-running-races/run-4k-wine-run-walk-plus-wine-tasting-2015-11462108?cmp=39-34&ltclickid=08_119491134_f37bbe56-b228-4209-8bf8-36b51be4e4de&ltcmp=254301

·    "Jingle Bell Run/Walk Seattle"- December 13, 2015.  This is a run/walk near Westlake Center in the Seattle area.  Spread your holiday cheer while raising monies to benefit research for the Arthritis Foundation.  You will see lots of holiday themed runners, booths and get a free beverage in their beer garden after!  http://www.jbr.org/faf/home/default.asp?ievent=1138396&lis=1&kntae1138396=CB96B4C15EAE467089E85385687EFD27 

Behind the scenes…What goes into my appointment?

If you’ve ever been to a doctor’s office, you may have wondered at some point...What exactly are they doing??   At Lake Washington Sports & Spine, our new patient consultations range from 45-60 minutes while follow up appointments range between 15-30 minutes.  Follow-ups can include imaging/lab reviews, checking your response to a previously done procedure and/or following up after you’ve completed recommendations set forth by the doctor.  A lot of patients do not recognize the time and effort that is put into each appointment from start to finish.  We want to share with you a “look behind the scenes” at what we are doing to ensure YOU have the best experience and care with us!

Front Office…Our front office staff includes the patient care coordinator and billing manager.  They work together to make sure the appointments are scheduled correctly, any necessary insurance authorization or other provider chart notes have been obtained and direct calls to the appropriate staff.  Overall, they make sure that scheduling, check-in and check-out run smoothly. 

The patient care coordinator is the first face you see when you walk in.  They contact patients to make sure they arrive on time for their check-in time and organize patient paperwork all the while answering phones with great customer service.  They explain referrals/orders to patients upon check-out and work with the rest of the staff to make sure the patient has everything they need before they leave.  They work to send your medical records to the appropriate clinics and facilities. The coordinator also schedules your follow-up appointment as you check out, and works with you to find the best day and time available. 

The billing manager checks insurance eligibility for patients and contacts them prior to their appointment with any concerns.  They answer insurance-related questions in real-time that either the patients or doctors may have, as well as discuss balances due with the patients.  They work with the medical assistants and doctors during appointments especially before procedures are done and/or scheduled in order to ensure all aspects of the procedure billing goes well.  They code and bill claims that require immediate payment as you check-out so you leave with a zero balance.

Clinical Staff… Our clinical staff includes the medical assistants to both our fabulous doctors!  They arrive early to prepare the day for the doctors so when patients are ready to be roomed they have the full appointment time booked with the doctor.  That is why it is so important for our patients to arrive at their check-in time versus their appointment start time.

The medical assistants typically review the chart notes for upcoming patients a day or two ahead of time.  If a patient is scheduled for an imaging and/or lab review appointment, they double check with the other facilities to make sure the images and reports are completed.  If the patient has not completed the needed orders, they work with the patient care coordinator to contact the patient in order to reschedule their appointment and/or find out when the orders will be done.  For patients following up for an in-office procedure, the medical assistants set up the equipment needed ahead of time for the doctor and also make sure necessary injectables are ready to be used (like PRP kits, Euflexxa, steroids, ect). 

Throughout the day, the medical assistants are constantly prepping for the next appointment, while also answering and returning patient calls.  They clean and prepare exams rooms before each appointment and work with each other to ensure that each doctor has access to the room/equipment he needs.  The medical assistants also input data from new patient and follow-up paperwork and generate referrals your doctor may recommend.

This is just a small glimpse into the amount of work being done to make sure you have a 5 star experience at Lake Washington Sports & Spine.  Our team is dedicated to keeping you active and we will ALWAYS go above and beyond to ensure that you receive the best musculoskeletal care around!